Provider Demographics
NPI:1790364131
Name:GENNOCRO, JANICE M (NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:GENNOCRO
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:6941 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-3022
Mailing Address - Country:US
Mailing Address - Phone:716-629-3338
Mailing Address - Fax:716-304-6571
Practice Address - Street 1:3950 E ROBINSON RD STE 109
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2042
Practice Address - Country:US
Practice Address - Phone:716-629-3338
Practice Address - Fax:716-304-6571
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-10-20
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Provider Licenses
StateLicense IDTaxonomies
NYF347137-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
F347137-01OtherLICENSE NUMBER